TASYL Membership Application Form

___ Full Membership (Licensed YL)

___ Associate Membership (___ Unlicensed YL or ___ OM)

Date _______________

Name _________________________________________ Call ______________

Address ____________________________________

City ______________________ State ________ Zip ____________

Phone _________________________

E-mail _________________________

Birthdate (day and month) _________________________

I am a member of ___ YLRL      ___ ARRL.

 

My OM’s Call _____________ OM’s Name _____________________________

___ Please add an Associate Membership for my OM (add $5 per year)

Directions: Print this page.  Fill in the appropriate blanks.
Send completed application with check for $5
($10 to add Associate Membership for OM--$5 for each) to TASYL secretary/treasurer:

Sylvia Hutchinson, K8SYL
9145 Bliss Rd
Lake Odessa, MI 48849

E-mail: sylvia (at) k8ch .net